What complication is associated with Boerhaave syndrome?

Boerhaave syndrome is characterized by the spontaneous rupture of the esophagus, often due to severe vomiting or other forms of increased intraesophageal pressure. One of the recognized complications of this syndrome is surgical emphysema.

Surgical emphysema occurs when air escapes from the esophageal rupture into the surrounding tissues, particularly into the mediastinum or subcutaneous tissue. This condition can lead to the development of crepitant tissue in areas where air should not normally be present, typically observed upon physical examination or imaging studies. The accumulation of air can also result in significant swelling and discomfort.

In contrast, while esophageal stricture and pneumothorax can occur in other contexts, they are not direct complications of Boerhaave syndrome. Sepsis, while a possible result of any severe infection, specifically relates to the presence of infection due to the rupture's complications but is not as immediate or characteristic as surgical emphysema. Understanding the pathophysiological process in Boerhaave syndrome highlights why surgical emphysema is a prominent concern for medical professionals dealing with such cases.